VacStent as an Innovative Approach in the Treatment of Anastomotic Insufficiencies and Leakages in the Gastrointestinal Tract-Review and Outlook.
Alexander YohannesJudith KnievelJonas LangeArno J DormannUlrich HügleClaus F EisenbergerMarkus M HeissPublished in: Life (Basel, Switzerland) (2024)
Anastomotic insufficiencies are severe complications of abdominal surgery, often leading to prolonged hospitalization, serious tissue inflammation, and even sepsis, along with the need for recurrent surgery. Current non-surgical treatments such as self-expanding metal stents (SEMSs) and endoscopic vacuum therapy (EVT) have limitations, including stent migration or perforation. This review evaluates the effectiveness of the VacStent GI TM (Möller Medical GmbH, Fulda, Germany), a novel medical device combining SEMS and negative-pressure wound therapy in treating gastrointestinal leaks. Data were gathered from four prospective studies and compared with existing treatments. Studies on the VacStent GI TM application demonstrate technical success and competitive closure rates in upper gastrointestinal leaks, with minimal complications reported. Comparative analyses with SEMS and EVT reveal promising and most importantly equally good outcomes while maintaining the possibility for sustained enteral nutrition and reducing the risk of stent migration. The VacStent GI TM presents a promising alternative to current non-surgical treatments. Ongoing research aims to validate its efficacy in lower gastrointestinal leaks and comprehensively establish its role in leak management. Further investigation is necessary to confirm these findings and optimize treatment protocols. Future usages of the VacStent GI TM in colonic anastomotic insufficiencies promise an effective approach and might be able to lower the rates of necessary implementations of a stoma.
Keyphrases
- rectal cancer
- healthcare
- randomized controlled trial
- oxidative stress
- minimally invasive
- intensive care unit
- systematic review
- risk factors
- acute kidney injury
- physical activity
- type diabetes
- single cell
- bone marrow
- gene expression
- coronary artery bypass
- electronic health record
- early onset
- mesenchymal stem cells
- dna methylation
- coronary artery disease
- atrial fibrillation
- surgical site infection
- adipose tissue
- acute coronary syndrome
- weight loss
- skeletal muscle
- drug induced
- ulcerative colitis
- machine learning
- cell therapy